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Sever back pain after lifting weight. MRI of the lumbar spine showing scoliosis, disc bulge and nerve root compression. Can you elaborate?

Sir, I am Dr.Santhosh, i m preparing for my Pg entrance examination which are coming up in a month.Since 6 weeks i m experiencing severe constant pain at L2 to L4 area of my back, this started since i lifted heavy weight.. I m taking rest at home,but d symptom didn t improve. I consulted an orthopaedician, he advised me to get an MRI done for my Lumbar spine , The report came with the following impression - Normal study except subtle scoliosis of the lumbar spine with convexity to left side due to ? muscle spasm and mild central disc bulge seen indenting adjacent anterior thecal sac at L4-L5 level. - No evidence of nerve root compression. now d dr advised me to get a bonescan done.. What may be the indication for the bone scan? Thanks.
Asked On : Wed, 21 Nov 2012
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Spine Surgeon 's  Response
Hi Dr Santhosh
Thank you for your question to HCM.

Muscle spasm is possibly a result of your weight lifting activity. From your description you back pain seems very likely from muscle strain. MRI is sensitive to detect pathological lesions in the spine causing back pain. Disc bulges with nerve compression commonly cause leg pain but the disc bulge with no nerve compression as described in your report is unlikely to be causing back pain.

The reason for bone scan may be a suspicion for spondylolysis which is one of the causes of back pain in teenagers. However, MRI would demonstrate hyperintensity indicating edema around the lysis. A CT scan will confirm the diagnosis of spondylolysis. The bone scan in your case is likely ordered to doubly rule out the possibility of spondylolysis.

Hope this is helpful. Let me know if I can be of further assistance. Wish you the best for upcoming exams.

Answered: Mon, 9 Sep 2013
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